The Transplant Evaluation
Evaluating your Heart Disease
To decide if you will benefit from heart transplantation,
it is necessary for the transplant team to evaluate
your heart disease. Typically you will be admitted
to the hospital overnight. During this time, you
will undergo a series of tests and interviews.
The tests included in the evaluation are:
- Chest X-ray: An X-ray of your heart and lungs
- Electrocardiogram (EKG): A view of the electrical
activity of your heart from monitor patches
on the skin
- Echocardiogram: An ultrasound of the heart,
this allows us to evaluate the size and function
of the heart muscle as well as the function
of the valve
- Exercise stress test: A test to determine
how well your heart can supply the oxygen needed
to your tissues. You will be asked to walk on
a treadmill while your heart and oxygen levels
are monitored.
- Cardiac catheterization: A procedure to measure
the pressure in your heart and lungs. This is
done by passing a catheter into your heart through
a vein in your groin or neck. Dye will then
be injected into the coronary arteries through
the catheter. This will determine if there are
any blockages in the coronary arteries.
Evaluating your General Health
The following tests will be performed to determine
your overall, general health:
- Pulmonary function test (PFT): This test involves
breathing through a tube to determine air volumes
in your lungs. The test helps determine whether
you have any lung conditions which might become
a problem after transplant.
- TB test and anergy panel: In order to determine
if you have ever been exposed to tuberculosis,
a skin test will be placed. The skin test is
placed and read in 48 hours. This will also
tell us how well you immune system is functioning.
- Blood tests: Several tubes of blood will be
drawn to test for your blood type, tissue type,
kidney and liver function, thyroid function,
blood cell counts and blood chemistries. A prostate
specific antigen (PSA) is drawn on all men to
determine if there is any indication of prostate
disease.
- 24 hour urine collection: A collection of
urine for 24 hours to determine kidney function
- Peripheral vascular/carotid artery studies:
Tests using sound waves to determine blood flow
to the major blood vessels in the body. It will
determine if there are any blockages in the
peripheral blood vessels.
- Abdominal ultrasound: A test using sound waves
to view your abdominal organs and blood vessels
to check for cysts, masses and aneurysms.
We will also ask you for general information
about your health including your history of immunizations
and a dental evaluation. For women, a gynecological
examination and mammogram, if applicable, will
be evaluated. We will not evaluate any patient
for transplant who is actively smoking, nor will
we evaluate a patient with active drug or alcohol
abuse.
Occasionally, we discover certain conditions
that make a heart transplant inadvisable, such
as an infection, high pressure in your lungs or
severe ulcer disease. We will discuss these issues
if they arise and help you determine an appropriate
treatment for your heart failure.
Meeting the Team
In addition to testing, you will meet with
the members of the Heart Failure/ Transplant team.
You will meet with the:
- Social worker, who will evaluate your support
systems, prescription coverage and provide general
counseling for you and your family
- Dietician, who will instruct you on the proper
diet
- Financial coordinator, who will give counseling
on prescription and insurance coverage
- Transplant coordinator, who will explain all
aspects of the evaluation process as well as
what to expect after transplant
- Cardiologist, who will discuss medical treatment
- Surgeon, who will discuss surgical treatment
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